A coalition/partnership will be created between the Edward Via - Virginia College of Osteopathic Medicine (VCOM) and eight community hospitals located throughout underserved regions of Appalachia to form a medical library network that will provide internet access to digital library information. Medical library resources in the proposed DLN region are almost nonexistent in this sparsely populated area. Although the Internet is available to hospitals in the region, this resource is infrequently/rarely utilized for library purposes. The participants in this project will create an Internet based Digital Library Network (DLN) to enhance library I resources and medical information for the region. Computer workstations will be provided to DLN hospital participating sites. Printers will be provided. A server will be dedicated to the network and housed at VCOM. A web page portal will be designed with special attention given to the development of a user-friendly interface. Links will be provided to Internet based digital materials including: NLM resources, purchased electronic resources (MDCONSULT and OVID), online CME materials and free web medical education resources. On site training in Internet access to digital library resources and search methodologies is a fundamental component of this proposal. Two trainer/facilitators will present specific training programs at all eight hospital sites quarterly. Training will occur at VCOM quarterly. Online training exercises will be developed and presented in the 2nd, 3rd, and 4th quarters that will instruct users about the utilization of internet based library materials in the practice of evidence based medicine. Participants will be able to use the web-portal for educational programming, lectures and streaming video presentations that will emanate for VCOM. Participants will have access to a medical librarian via email, fax and telephone. The librarian will bring library search capabilities to these rural sites and respond user questions about advanced search techniques and methods. An information technology helpdesk will be developed and available to users that have specific queries concerning hardware/software problems associated with this project. Evaluative methods will be utilized to measure user satisfaction and perceived improvements in rural healthcare delivery based upon the increased use and access to this technology.